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Didn't see that the CaRMS stats were out until now, a few weeks after the fact, but wanted to get a competitiveness breakdown out there, particularly given the difficulties experienced with this year's match. I've attached the full data set, but wanted to highlight the larger specialties directly here as well as offer a few comments. As always, my preferred metric for competitiveness is the percentage of individuals who rank a specialty first overall who match to that specialty. Those matching to an alternative discipline are also listed, as it provides a sense of how easy it is to back-up to another specialty when shooting for a particular first choice specialty. This metric is not a perfect representation of competitiveness, nor is it the only one available, but given available stats I believe it has the most value to those approaching the match and deciding on their CaRMS strategies. All stats are for the 1st iteration and for CMGs only.

1) Across the board, a competitive year for surgical disciplines. These specialties have slowly been losing residency spots due to their generally poor job markets, but demand seems to have largely stayed put despite this, driving competition up. With over a quarter of people applying to Gen Sx, ENT, and Plastics going outright unmatched in the first round, and over 15% in pretty much all other surgical disciplines speaks to the risks involved going down that career path. To be a surgeon these days, you've got to really want it, and fight for your spot.

2) By contrast, certain moderate and high competitiveness specialties can be rather safe with an appropriate back-up plan. Derm and OBGYN have overall combined match rates (first choice + alternative) close to the weighted average of all specialties. More people who picked Derm first ended up in a back-up specialty than in Derm itself, a figure fairly consistent with previous years. Part of this may be driven by those with weak interest in the field - say a person who is essentially going for FM but taking a long-shot on a Derm program on the off-chance it works out - but considering that obtaining a Derm interview in the first place isn't a guarantee, I think there's something to be taken away by those specific numbers.

3) Likewise, two specialties this year had a combined match rate better than FM, generally considered the safe specialty to apply to - namely, IM and Peds. Here I do think individual circumstances play a role that prevents a simple interpretation of these numbers, as those who pick FM first tend to apply less broadly than those going for specialties, and most of those backing up from IM and Peds will end up in FM. Still, there was a growing inclination that Peds and increasingly IM were competitive enough that you had to gun for them like you would a surgical specialty, ignoring a back-up entirely, and I don't think that's true at all. Back-ups remain viable, especially in these specialties, if approached correctly.

4) Rads continues on the pathway towards non-competitiveness, a journey it's been on in fits and spurts for half a decade now. As someone who gave Rads a good hard look in pre-clerkship without ever really coming around to the field, I'd be very interested in exploring what's driving this trend. My guess is a combination of increasing work requirements, slowly declining incomes (though still exceptionally high, even by doctor standards), and a growing medical student preference for patient contact are the main drivers, but even that seems like it's missing something.

5) As was already apparent, this was a rough match overall. Too many left without a residency position after the first round and as is now being exposed, medical schools and provincial governments had no real plan to address this. Now that the dust has settled, the last-minute efforts to provide emergency residency spots in Ontario, plus the military opening up additional spots after the match, have helped improve the immediate crisis. Yet, the underlying math of the situation has yet to really change. As we approach the time when the final residency numbers get set, here's hoping some more wiggle room enters the system. While the vast majority of graduating CMGs will have a good outcome, even if nothing changes, that bad outcomes for a small subset are now virtually assured is very concerning. For all those reading, please remember that unmatched CMGs are more than ever victims of circumstance and should not automatically be considered weaker or flawed candidates.

One mildly frustrating change with the reported stats this year is that CaRMS has not provided the numbers for people who match to a given specialty when it is not their first choice. That makes it harder to identify specialties that are good options to back-up into, though I strongly suspect this continues to be FM and IM.

Lastly, a few caveats on the data above. First, this works off of first choice rankings, which are not always straight-forward. Some individuals will put a single program in one specialty followed by a ton in a second. Some will want a particular specialty but get no interviews and be left with only their back-up options to rank first. Many will apply in a limited geographic area, or generally utilize a bad match strategy which results in them going unmatched for reasons that have little to do with their chosen specialty's competitiveness. Second, while I have listed all specialties in the excel spreadsheet attached, please interpret the smaller ones with caution. Lots of variability in these specialties year-to-year that make definitive conclusions almost impossible. Finally, some specialties have chosen to offer streams with slight differences from the standard program - such as those with an academic or research focus - that appear as a completely separate CaRMS discipline in the stats. This makes interpretation of these specialties much more complex, as these slightly different streams undoubtedly share the main applicant pool as their main streams. This means if someone wants, say, a Clinician Investigator Program as their first choice but would be perfectly happy with just the normal stream, if they end up matching to that normal stream, they're automatically shown as falling into a "second choice" program, even when they really didn't. This is particularly bothersome for the Public Health programs, which are split between "Public Health and Preventive Medicine" and "Public Health and Preventive Medicine including Family Medicine", but are essentially the same specialty. Same could be said of the lab-based programs, which are shades of the same thing under different names. There's not nearly enough transparency in residency matching and these shenanigans make what little data we have even worse.

If I've gotten anything wrong with the numbers, please let me know and I'll correct it ASAP. I try to double-check things but something can always slip through and sometimes the source material gets things wrong too.

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Thank you for this! So if someone ranked derm 1st and FM 2nd, but didn't receive derm interviews and only received FM interviews, is there 1st choice considered Derm or FM for these CARM stats?

If someone applied to both Derm and FM (and wanted Derm first), but didn't get any Derm interviews, they're not likely to rank any Derm programs (even though there's no downside to doing so). Rather, I'd expect most students in this position to start their rankings with FM. In this case, their "first choice" would be considered FM, not Derm, and while I don't think this is an overly common situation, it would skew the stats somewhat to make Derm look less competitive than it actually is.

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Theoretically you are allowed to rank every program you have applied to. In reality, people will rank programs they have interviewed at before the ones they did not interview at. To answer your question, it depends on the applicant, however generally, it is assumed that if an applicant does not receive interviews for what was their first choice specialty, they will rank the other specialty they applied to. Essentially the ranklist is submitted after interviews and therefore influenced by which interview the applicants receives.

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Quick update - when I first made this post, CaRMS data on specialties that applicants back up into was essentially missed. CaRMS has since updated the numbers, so I think a quick dig into those is worthwhile.

About 360 people backed up into a specialty - that is, they matched to a specialty that wasn't the one they ranked the highest. Over those, 290 backed up into either FM (228 applicants) or IM (62 applicants). Another handful backed up into the larger, moderately competitive specialties (11 to Psych, 10 to Peds), with scattered numbers elsewhere. The highly competitive specialties like Derm essentially have no one backing up into them, as could be expected. Split specialties that are essentially the same once again skew the numbers here a bit, such as with the research track programs, likely account for about 10 of the remaining slots and I'd call these backing up in name only.

All told, the situation is essentially the same as it has been for years - if you want to back up, chances are you'll be backing up with FM or IM. There's always a shot at backing-up to some other specialties - even relatively competitive specialties like Gen Sx and OBGYN get a few every year - but it's a riskier option and personal circumstances are likely major factors in walking that tightrope that public data just can't reveal. Overall, backing up remains a viable option for a lot of people who would be comfortable with something like FM or IM as a 2nd or 3rd choice option, so long as they approach their electives planning and CaRMS match strategically.

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Quick update - when I first made this post, CaRMS data on specialties that applicants back up into was essentially missed. CaRMS has since updated the numbers, so I think a quick dig into those is worthwhile.

About 360 people backed up into a specialty - that is, they matched to a﻿ specialty that wasn't the one they ranked the highest. Over those, 290 backed up into either FM (228 applicants) or IM (62 applicants). Another handful backed up into the larger, moderately competitive specialties (11 to Psych, 10 to Peds), with scattered numbers elsewhere. The highly competitive specialties like Derm essentially have no one backing up into them, as could be expected. Split specialties that are essentially the same once again skew the numbers here a bit, such as with the research track programs, ﻿likely account for about 10 of the remaining slots and I'd call these backing up in name only.﻿

All told, the situation is essentially the same as it has been for years - if you want to back up, chances are you'll be backing up with FM or IM. There's always a shot at backing-up to some other specialties - even relatively competitive specialties like Gen Sx and OBGYN get a few every year - but it's a riskier option and personal circumstances are likely major factors in walking that tightrope that public data just can't reveal. Overall, backing up remains a viable option for a lot of people who would be comfortable with something like FM or IM as a 2nd or 3rd choice option, so long as they approach their electives planning and CaRMS match strategically.﻿

The cases where people "backed up" into more competitive specialties could be people who were focusing on location and were competitive for multiple specialties and so their 2nd rank was actually their alternate specialty as you alluded to.

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The cases where people "backed up" into more competitive specialties could be people who were focusing on location and were competitive for multiple specialties and so their 2nd rank was actually their alternate specialty as you alluded to.

Absolutely. Being geography-constrained and going for competitive specialties still means a risky match overall, but by focusing heavily on only a few programs (especially if it's at the home school), it opens up some back-up options that might not be as feasible when applying cross-country for the 1st choice specialty.